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Clinicopathological characteristics, diagnosis, treatment, and outcomes of primary gastric adenosquamous carcinoma.

Chen H, Shen C, Yin R, Yin Y, Chen J, Han L, Zhang B, Chen Z, Chen J - World J Surg Oncol (2015)

Bottom Line: The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm).Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components.The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. hnchen7@gmail.com.

ABSTRACT

Background: Primary gastric adenosquamous carcinoma (ASC) is a rare subset of ASC. This study aims to investigate the clinicopathological features, diagnosis, treatment, and outcomes of primary gastric ASC.

Methods: The medical records of 13 consecutive patients with primary gastric ASC between January 2010 and July 2014 from a single institutional database were reviewed.

Results: Male predominance was observed (M/F = 10/3) among the patients, and their median age was 62 years (range: 43 to 79 years). The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm). Ten patients underwent radical resections (R0 resection, 76.9%), while three patients had palliative resections (R1/R2 resection, 23.1%). Twelve patients had lymph node metastasis at the time of surgery. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components. In terms of the TNM staging system, stages IIB, IIIA, IIIB, IIIC, and IV were detected in 2 (15.4%), 2 (15.4%), 1 (7.7%), 5 (38.5%), and 3 (23.1%) patients, respectively. The median follow-up period was 22 months (range: 5 to 52 months); during which, four patients were still alive and eight patients died because of tumor progression. The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively.

Conclusions: Primary gastric ASC has a very poor prognosis, and both squamous cell carcinoma and adenocarcinoma components have distant metastasis potential.

No MeSH data available.


Related in: MedlinePlus

ASC characterized as a mixture of SC and AC. Both squamous cell carcinoma and adenocarcinoma components were found (A: hematoxylin-eosin staining, ×200; B: hematoxylin-eosin staining, ×400); Immunohistochemistry of p63 protein that was positive in the squamous cell carcinoma area (C: ×400), and positive staining for adenocarcinoma cell with CEA (D: ×400).
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Fig1: ASC characterized as a mixture of SC and AC. Both squamous cell carcinoma and adenocarcinoma components were found (A: hematoxylin-eosin staining, ×200; B: hematoxylin-eosin staining, ×400); Immunohistochemistry of p63 protein that was positive in the squamous cell carcinoma area (C: ×400), and positive staining for adenocarcinoma cell with CEA (D: ×400).

Mentions: Table 2 shows the pathological characteristics of the 13 primary gastric ASC patients. ASC was characterized as a mixture of SC and AC (Figure 1). Most squamous cell carcinoma components had the characteristics of individual cell keratinization, keratin pearl, or intercellular bridge, among others. Seven patients underwent immunohistochemical examination. Both CEA and CK7 were positive in all AC of tumor or AC of metastatic lymph node; however, SC with these two antibodies were weakly positive in one and three cases, respectively. P63 expression was positive in the squamous cell carcinoma component in six patients but negative in adenocarcinoma components. No patient had positive expression of CgA and Syn. The tumor invaded the visceral peritoneum (T4a) and adjacent tissues (T4b) in six and three cases, respectively. A total of 359 lymph nodes were moved; among which, 106 had metastases. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components (Figure 2).Figure 1


Clinicopathological characteristics, diagnosis, treatment, and outcomes of primary gastric adenosquamous carcinoma.

Chen H, Shen C, Yin R, Yin Y, Chen J, Han L, Zhang B, Chen Z, Chen J - World J Surg Oncol (2015)

ASC characterized as a mixture of SC and AC. Both squamous cell carcinoma and adenocarcinoma components were found (A: hematoxylin-eosin staining, ×200; B: hematoxylin-eosin staining, ×400); Immunohistochemistry of p63 protein that was positive in the squamous cell carcinoma area (C: ×400), and positive staining for adenocarcinoma cell with CEA (D: ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4389966&req=5

Fig1: ASC characterized as a mixture of SC and AC. Both squamous cell carcinoma and adenocarcinoma components were found (A: hematoxylin-eosin staining, ×200; B: hematoxylin-eosin staining, ×400); Immunohistochemistry of p63 protein that was positive in the squamous cell carcinoma area (C: ×400), and positive staining for adenocarcinoma cell with CEA (D: ×400).
Mentions: Table 2 shows the pathological characteristics of the 13 primary gastric ASC patients. ASC was characterized as a mixture of SC and AC (Figure 1). Most squamous cell carcinoma components had the characteristics of individual cell keratinization, keratin pearl, or intercellular bridge, among others. Seven patients underwent immunohistochemical examination. Both CEA and CK7 were positive in all AC of tumor or AC of metastatic lymph node; however, SC with these two antibodies were weakly positive in one and three cases, respectively. P63 expression was positive in the squamous cell carcinoma component in six patients but negative in adenocarcinoma components. No patient had positive expression of CgA and Syn. The tumor invaded the visceral peritoneum (T4a) and adjacent tissues (T4b) in six and three cases, respectively. A total of 359 lymph nodes were moved; among which, 106 had metastases. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components (Figure 2).Figure 1

Bottom Line: The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm).Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components.The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. hnchen7@gmail.com.

ABSTRACT

Background: Primary gastric adenosquamous carcinoma (ASC) is a rare subset of ASC. This study aims to investigate the clinicopathological features, diagnosis, treatment, and outcomes of primary gastric ASC.

Methods: The medical records of 13 consecutive patients with primary gastric ASC between January 2010 and July 2014 from a single institutional database were reviewed.

Results: Male predominance was observed (M/F = 10/3) among the patients, and their median age was 62 years (range: 43 to 79 years). The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm). Ten patients underwent radical resections (R0 resection, 76.9%), while three patients had palliative resections (R1/R2 resection, 23.1%). Twelve patients had lymph node metastasis at the time of surgery. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components. In terms of the TNM staging system, stages IIB, IIIA, IIIB, IIIC, and IV were detected in 2 (15.4%), 2 (15.4%), 1 (7.7%), 5 (38.5%), and 3 (23.1%) patients, respectively. The median follow-up period was 22 months (range: 5 to 52 months); during which, four patients were still alive and eight patients died because of tumor progression. The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively.

Conclusions: Primary gastric ASC has a very poor prognosis, and both squamous cell carcinoma and adenocarcinoma components have distant metastasis potential.

No MeSH data available.


Related in: MedlinePlus